Riel's melanosis
Introduction
Introduction to Riel's disease Riehls Melanosis This disease was first described by Riehls as a photo-sensitive disease, phototoxic dermatitis. It is characterized by facial marginal flaky pigmentation and slight telangiectasia, mild follicular keratosis and fine scales. basic knowledge The proportion of illness: this disease is rare, the incidence rate is about 0.0001% Susceptible people: no special people Mode of infection: non-infectious Complications: sepsis
Cause
The cause of Riel melanosis
Cause
It is believed that light-sensitive and mechanical stimuli are sensitive, and cosmetics containing tar-derived compounds cause light sensitivity, and malnutrition may also cause disease.
Pathological change
Epidermal hyperkeratosis and follicular keratin plug, mild atrophy of the spinous cell layer, liquefaction and degeneration of the basal cell layer, vascular expansion of the dermal surface hair cells, and increased melanocytes. There is cell infiltration around the blood vessels, mainly lymphocytes.
Prevention
Riel melanosis prevention
There is no effective preventive measure for this disease. Early detection and early diagnosis are the key to the prevention and treatment of this disease.
At present, some scholars believe that light sensitivity and mechanical stimulation are sensitive. Cosmetics containing tar derivatives cause light sensitivity, and malnutrition can also cause disease. Therefore, prevention should be based on the cause, avoid strong light and UV damage to the skin mucosa, avoid using skin care products containing tar and its derivatives, strengthen nutrition and eat more protein and vitamin-rich fish, shells, tomatoes, lemons, etc.
Complication
Riel melanosis complications Complications sepsis
The disease is a benign disease that usually heals itself after removing the infection and allergens. However, due to the destruction of skin integrity, it may cause skin bacterial infection or fungal infection due to scratching, usually secondary to low body constitution, or long-term use of immunosuppressive agents and fungal infections such as onychomycosis, such as concurrent bacterial infections may have Fever, skin swelling, ulceration and purulent secretion flow out. Severe cases can lead to sepsis, which should be brought to the attention of clinicians.
Symptom
Riel melanosis symptoms common symptoms itching skin black pigmentation spots local migratory erythema pigmentation and hypopigmentation scales
The disease begins with mild itching of the skin, erythema, pigmentation later, the pigmentation plaque is unclear, the pigment is shallow and deep, and gradually spreads, showing a light brown, taupe, brown, dark brown, with mild congestion at the pigmentation. Capillary vasodilation, the surface of the skin lesions are filled with thin scales, like a layer of flour, the skin may have mild atrophy and hyperkeratosis of the hair follicles, no change in mucosa, the main site of the disease is in the forehead, humerus, ear, Behind the ear and on both sides of the neck, the center of the face is rarely affected, and sometimes occurs in the friction parts such as underarms, umbilical fossa, forearms, chest, back of the fingers, near the hairline of the scalp, lighter color, chronic passage, damage development It will not change to a certain extent. Afterwards, the pigmentation spots will gradually become shallower, the hyperkeratosis will gradually disappear, and it will naturally heal. Tadokor reports that the incidence rate is 77:8 for males. 60% of patients have light sensitivity, which is found in the clinic. There are many female patients, and male patients are not uncommon. The disease generally has no systemic symptoms and no mucosal damage.
Examine
Riel melanosis check
Pathological section: epidermal hyperkeratosis and follicular keratin plug, mild atrophy of the spinous cell layer, liquefaction and degeneration of the basal cell layer, vascular expansion of the dermal surface hair cells, increased melanocytes, and cell infiltration around the blood vessels, mainly lymphocytes.
Diagnosis
Diagnosis and identification of Riel's disease
diagnosis
Diagnosis can be performed based on clinical manifestations and examinations.
Differential diagnosis
(1) Different from Civatte's skin heterochromia, Civatte's skin heterochromia occurs on the cheeks, neck, chest, reticular pigmentation, pale spotted skin atrophy and significant telangiectasia. The disease is marginal pigmentation on the forehead, ankle, front of the ear, behind the ear and neck, mild keratinization and thin scales, like a layer of powder on the face.
(2) Melanoder matitis toxica lichenoides is a long-term inhalation of asphalt, coal tar, oil or long-term inhalation of volatile substances of such substances, surface, sputum, itchy reticular pigment in the neck Spot, telangiectasia and black mossy hair follicle papules and acne-like inflammatory reactions are easily identified with this disease.
